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Thread: Nipple blanching & Clamping pain. Thrush?

  1. #1
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    Nov 2007
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    Default Nipple blanching & Clamping pain. Thrush?

    I posted this on the infant forum but realize it might be better suited on this one. Sorry for the redundancy to those who viewed this twice. My LO is 4 weeks old and BF is still killing me. For a while, I thought it was getting better but now the pain is back and in both breasts. It starts the minute he latches. It is so painful. The LCs and pedi that I saw said it was his clamping and that hopefully, he'd outgrow it. I've been crossing my fingers but I'm not so sure it will ever get better because it still hurts so much. After a feed, my nipple is blanched and creased. There is shooting pain during letdown and after the feed. Today, I was doing more research on the web and came across the symptoms of thrush and wonder if this could be thrush. Of course, like I said, I have a creased nipple afterwards so chances are it is not thrush and just LO sucking so hard (the LCs say the latch is correct). WOndering if anyone can shed some light on this. If it is the clamping (probably it is), is there anything I can do? I am desperate! I haven't used a bottle for the last few weeks but think I should introduce it soon for fear that LO won't take to one if I wait much longer. If this pain continues, I probably will need to pump and bottlefeed which breaks my heart. Thank you!
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    Last edited by BFmama; November 12th, 2007 at 08:28 PM.

  2. #2
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    Jan 2006
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    Default Re: Nipple blanching & Clamping pain. Thrush?



    Sore nipples are no fun. It sounds like your issue would be more related to your baby's latch/suck since you mention a compression stripe after nursing.


    The most common reason for nipple blanching is that that baby is compressing the nipple while nursing. This can be due to:

    *a shallow latch (the most common problem)
    *improper sucking
    *baby clamping down to slow a too-fast let-down
    *tongue-tie
    *baby clamping due to allergies
    *clampdown bite reflex
    *palate variations, etc.

    When blanching is due to baby's compression of the nipple, the nipple is white and often misformed (flattened, creased, pointed, etc.) immediately upon coming out of baby's mouth. There may be a white stripe across the nipple directly after nursing. Pain may not start until a few seconds to a few minutes after nursing, as the circulation returns to the nipple. If you are experiencing pain with the blanching, then finding and remedying the underlying cause will also eliminate the blanching.
    Source: http://www.kellymom.com/bf/concerns/...blanching.html

    You might find these resources helpful:
    http://parenting.ivillage.com/newbor...,,79mj,00.html
    http://www.llli.org//llleaderweb/LV/LVJulAug94p53.html

    My best suggestions are: 1) Make sure baby is relaxed before attempting nursing 2) Assure baby's mouth is open WIDE and his gums bypass the nipple and land far back on the areola 3) Vary nursing positions 4) Cover your nipple with a warm compress after nursing (will ease the pain as the blood returns to the nipple)

    If you haven't already, I would urge you to contact your local LLL Leader. She will be a great source of information and support.

  3. #3
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    Nov 2007
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    Default Re: Nipple blanching & Clamping pain. Thrush?

    Thanks for the suggestions but my LO is rarely relaxed at a feeding. He is crying hysterically. I've tried catching his early hunger cues but when I do, he falls asleep at the breast (despite numerous efforts to wake him). He also doesn't open wide despite many attempt at putting nipple to his lips, etc. It is so frustrating!

  4. #4
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    Default Re: Nipple blanching & Clamping pain. Thrush?

    Hi!
    You say you are having trouble spotting hunger cues? A good rule of thumb is every time they wake up they are hungry. Any tongue sticking in and out? Hungry. A baby that is feeling super anxious about feeding is one who is going to clamp and really suck hard. If I can briefly bore you with my own experience at that age I remember much back to back nursing. As in I could barely set him down and it was time to latch again. During a growing period, they can want to cluster feed which means they will want to nurse so often it feels like constantly.
    So here are some thoughts on getting a over wrought baby to relax...
    1. take a nice cozy bath together (did umbilical cord fall off yet?)
    2. wear baby in a sling, and walk around ( they love mama's heart beat)
    3. have your partner do a lap around the house with baby while humming a tune
    Have you called your local LLL leader for tips on latching? What positions are you nursing in? Does baby slip off nipple? If baby sucks on your finger can you feel the tongue firmly on the bottom? Does any are of the nipple hurt more?-top or bottom?

    *tricks* for an "open up wide" baby!

    When baby is in nursing position tickle the lip until baby is wide wide wide open, then pull baby close to you ( don't lean the breast into the mouth). You can try a gentle finger on the chin (no pushing- just use the weight of your finger) to encourage a wider mouth. If that seems to fail, try the opposite. A finger below the chin softly pressing close (briefly) can make muscles resist and actually open mouth instead of close it.

    I agree that it is a probably latching issue, and most likely not thrush.

  5. #5
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    Sep 2007
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    Default Re: Nipple blanching & Clamping pain. Thrush?

    I definitely feel for you! I had the same problem for about the first 2 months, where it felt like my nipples were being pinched and twisted whenever DS fed. After he was finished they were blanched and there was a ridge on the underside of my nipples (like they had been partly flattened). I couldn't figure out what was going on because I was trying to do everything the books describe. While I'm pretty sure that part of it had to do with an overactive letdown and he was clamping down to ease the flow, part of it also had to do with positioning. The football hold worked well because he was in a more upright position, and could control the flow better, but the cradle hold was very painful. One of the things that caused me problems was my nursing pillow, and it took me a surprisingly long time to figure out, but it was just the wrong height for my breasts & body. So even though his latch was great, it put DS up just a little too high and so my nipples actually were twisting a bit when he fed . I found that a regular pillow worked better at supporting him at the right height. It also really helped me to have an experienced breastfeeding mama (there isn't a lactation consultant or LLL leader in my town) figure out how I should be positioning him in the cradle hold that worked better for me (the textbook tummy to tummy just didn't work well for me due to the size/shape of my breasts). It was a lot easier for her to figure out a positioning solution since she was looking straight on rather than down.

    For the fast letdown issue, someone else already suggested reclining and having your baby more on top of you when you begin feeding and that really works. You can slowly ease yourself into a more upright position, once the initial flow slows down. If it is an overactive letdown it gets easier as they get bigger because they are better able to handle it. I really hope that experimenting with different bf positions will help you out, and I hope this post makes sense - as I was kind of rambling...However, hang in there, you'll find the solution and it will get better!

  6. #6
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    Nov 2007
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    Default Re: Nipple blanching & Clamping pain. Thrush?

    I have been doing the football hold. All other positions seem to hurt more or are very awkward. I've also tried different pillows, etc but it still hurts the same. I think I may have the overactive letdown and I've tried reclining. It feels really weird though because it feels like LO is tugging my nipple downwards when he sucks. LO also refuses to open really wide. I've tried tickling his lips and that only gets him to open a little bit. When he yawns, his mouth is huge. I want him to open it like that but he doesn't. Don't know what else to do. I really hope this gets better soon.

  7. #7
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    Sep 2007
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    Default Re: Nipple blanching & Clamping pain. Thrush?

    I just thought of something when I was feeding my LO a little while ago, that I had totally forgotten about last night when I posted. All the nurses at first told me that his latch was great even though it hurt, but I discovered after reading this article of the Dr. Sears website- http://www.askdrsears.com/html/2/T021000.asp - that DS didn't quite have his bottom lip flipped out enough. I started going the "Martha Sears" lip flip, and that helped over time, along with repositioning. The article also has tips on how to help your baby open wide.

  8. #8
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    Nov 2007
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    Default Re: Nipple blanching & Clamping pain. Thrush?

    i'll have a look. thanks!

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